Experience Counts With Coronary Bypass Surgery

Study says hospitals that handled more than 200 a year showed better survival rates

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MONDAY, Aug. 9, 2004 (HealthDayNews) -- Hospitals and surgeons that handle many coronary bypass cases each year offer better survival rates for such patients, says a study in the Aug. 9 online issue of Circulation.

The study of more than 57,000 bypass patients in New York found these low-risk patients had a 47 percent lower in-hospital death rate when treated at hospitals that performed at least 200 bypass procedures a year, compared with hospitals that did fewer than that each year.

Moderate- and high-risk patients had a 38 percent lower death rate in higher-volume hospitals compared to lower-volume hospitals.

There was a 48 percent lower death risk for low-risk patients operated on by surgeons who did at least 125 procedures per year in hospitals that did more than 600 bypass operations a year compared with surgeons who did at least 125 procedures a year in hospitals than did less than 600 a year.

"For all patients, not just those at high risk of mortality, high-volume providers -- both hospitals and surgeons -- are associated with a lower risk of death," study author Dr. Chuntao Wu, an assistant professor of epidemiology at the School of Public Health at State University of New York in Albany, said in a prepared statement.

Previous studies found the benefit of high-volume hospitals is limited to high-risk bypass patients. That's led to suggestions that only high-risk patients be referred to high-volume hospitals.

"Our findings support applying a volume-based referral to all bypass patients, not just those at high risk. But performing most bypass surgeries in high-volume hospitals could overburden them and cause hardships for many patients," Wu said.

He and his colleagues suggest it would be better to improve quality of care at all hospitals instead of sending the majority of bypass patients to high-volume hospitals.

More information

The U.S. National Library of Medicine has more about bypass surgery.

SOURCE: American Heart Association, news release, Aug. 9, 2004

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